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continued:

Pacifiers: Are they good for your baby?

Pacifier do's and don'ts

If you choose to offer your baby a pacifier, keep these tips in mind:

  • Wait until breast-feeding is well established. Be patient. It might take a few weeks or more to settle into a regular nursing routine. If you're breast-feeding, the American Academy of Pediatrics recommends waiting to introduce a pacifier until four to six weeks after birth.
  • Don't use a pacifier as a first line of defense. Sometimes a change of position or a rocking session can calm a crying baby. Offer a pacifier to your baby only after or between feedings. Don't allow your child to use the pacifier all day.
  • Choose the silicone one-piece, dishwasher-safe variety. Pacifiers made of two pieces pose a choking hazard if they break. Once you've settled on a favorite pacifier, keep a few identical backups on hand.
  • Let your baby set the pace. If your baby's not interested in the pacifier, try again later — or skip it entirely. If the pacifier falls out of your baby's mouth while he or she is sleeping, don't pop it back in.
  • Keep it clean. Before you offer your baby a pacifier, clean it thoroughly. Until your baby is 6 months old and his or her immune system matures, frequently boil pacifiers or run them through the dishwasher. After age 6 months, simply wash pacifiers with soap and water. Resist the temptation to "rinse" the pacifier in your own mouth. You'll only spread more germs to your baby.
  • Don't sugar coat it. Don't put sweet substances on the pacifier.
  • Keep it safe. Replace pacifiers often, use the appropriate size for your baby's age, and watch for loose parts or signs of deterioration. Also use caution with pacifier clips. Never use a string or strap long enough to get caught around your baby's neck.

The bottom line

To reduce the risk of SIDS, the American Academy of Pediatrics recommends offering a pacifier at naptime or bedtime until age 1. However, the risks of pacifier use begin to outweigh the benefits as your baby gets older. While most kids stop using pacifiers on their own between ages 2 and 4, others need help breaking the habit.

Depending on your child's age, consider these techniques to wean your child from the pacifier:

  • Younger infants. Swaddling, rocking, singing, playing soft music and infant massage can be effective alternatives to pacifier use.
  • Older infants and toddlers. Activities, toys or other objects of affection, such as a blanket with satin edging, might help distract your child from his or her desire for the pacifier.
  • Toddlers and older children. Consider holding a special ceremony to bury or otherwise discard the pacifier — or allow your child to trade in his or her pacifier for a special book or toy. Your child's dentist might also be able to help your child stop using the pacifier by explaining the potential impact of prolonged pacifier use on his or her teeth.

If you need additional help weaning your child from the pacifier, consult your child's doctor or dentist.

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References
  1. Sexton S, et al. Risks and benefits of pacifiers. American Family Physician. 2009;79:681.
  2. O'Connor NR, et al. Pacifiers and breastfeeding. Archives of Pediatrics & Adolescent Medicine. 2009;163:378.
  3. Hanzer M, et al. Pacifier use does not alter the frequency or duration of spontaneous arousals in sleeping infants. Sleep Medicine. 2009;10:464.
  4. Rovers MM, et al. Is pacifier use a risk factor for acute otitis media? A dynamic cohort study. Family Practice. 2008;25:233.
  5. The changing concept of sudden infant death syndrome: Diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk. Pediatrics. 2005;116:1245.
  6. Thumb, finger and pacifier habits. American Academy of Pediatric Dentistry. http://www.aapd.org/publications/brochures/tfphabits.asp. Accessed May 4, 2011.
  7. Hebling SR, et al. Relationship between malocclusion and behavioral, demographic and socioeconomic variables: A cross-sectional study of 5-year-olds. The Journal of Clinical Pediatric Dentistry. 2008;33:75.
  8. Berkowitz CD. Thumb sucking and other habits. In: Berkowitz CD. Berkowitz's Pediatrics: A Primary Care Approach. 3rd ed. Washington, D.C.: American Academy of Pediatrics; 2008:1.
  9. Shelov SP, et al. Caring for Your Baby and Young Child: Birth to Age 5. 5th ed. New York, N.Y.: Bantam Books; 2009:58.
  10. Schwartz RH, et al. Infant pacifiers: An overview. Clinical Pediatrics. 2008;47:327.
  11. For the dental patient: Thumb sucking and pacifier use. Journal of the American Dental Association. 2007;138:1176.
  12. Nowak AJ, et al. Oral habits and orofacial development. http://www.uptodate.com/home/index.html. Accessed May 4, 2011.
  13. Holt K, et al. Bright Futures Nutrition. 3rd ed. Elk Grove Village, Ill.: American Academy of Pediatrics; 2011:32.
PR00067 Aug. 27, 2011

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